Posts tagged stitches
I have no idea what is with my kids, mostly Nora, and head injuries. I’m not talking about serious ones that might be life altering, but simply the ones that involve hitting, banging, or cutting the head. If you know us personally or have followed my blog in the past (yes, I know I haven’t blogged in a while) then you’ve seen my posts on facial lacerations including stitches and dermabond here, here , here and here. I know it seems crazy that I have four posts related to facial injuries, scars, stitches, etc but it’s our reality. But the saga continues!
Back on February 16th Nora had a run in with a wall, specifically the place where two walls meet at a corner in a doorway. Scott and I had literally just sat down to eat dinner and the girls were supposed to be watching a TV show before bed. Well, whenever Scott and I try to eat a nice dinner by ourselves, Nora is always coming and checking up on us. I heard her start to come down the hall but didn’t think anything of it. She wasn’t even running, which is amazing in itself. Then, all of a sudden Scott and I heard the loudest bang we’ve ever heard inside our house. He looked right at me and said, “This is going to be bad!” I dropped my fork and ran to the hall to find Nora on the floor screaming her little head off. I scooped her up into my arms and that is when I saw the blood on her forehead. There was a lot of it. Somehow I have the ability to remain pretty calm in these type of situations and I told Scott to get me a towel so I could apply pressure to the wound. It was hard to tell right away the severity of the wound and not knowing exactly what to do, we decided to call 911. Nora was pretty hysterical and kept saying she was tired and was starting to hyperventilate a bit.
I sat on the kitchen floor, cradling Nora while holding the towel over her wound while Scott stood watch for the EMTs, firefighters and police officers. Oh yes, we had all of those people at our house that night. In less than five minutes the firefighters arrived, two big stalky guys came into the house and we were all crouched on the kitchen floor. They were the nicest guys ever and asked about what happened and looked at the wound. They agreed that it was pretty bad and determined that she didn’t have a concussion. They wrapped her head with gauze to cover the wound. The EMTs arrived next along with a police officer. We decided not to go to the hospital in an ambulance for a few reasons – 1. It was almost 8pm and I wanted Brinely to be able to get to bed (she was pretty upset about the whole situation) and if we went in the ambulance Scott and Brinley would have to come pick us up when we were done, and 2. They wanted to strap Nora to a backboard for the ride. Since the bleeding had stopped, she didn’t have a concussion, and she was already pretty upset, I thought that strapping her to a backboard and putting her in the ambulance would just have been too much trauma for her for one night.
So after all the emergency responders had left, I took Nora and drove her to the nearest hospital. On the way there I kept talking to her to make sure she was ok and that she didn’t fall asleep. It also started to rain which I didn’t think much of until we arrived at the hospital and there was no where to park near the ER. I circled around a few times but nothing opened up so I had to park on the other side of the parking lot an carry Nora, in the rain, over to the ER. Granted it wasn’t that far, but it just added to the chaos.
Once inside, we checked in and had a seat in the waiting room. She was initially checked out pretty quickly by the intake nurse and I though this would be a quick visit, but boy was I wrong. We sat and sat in that waiting room for an hour, then two hours, then nearly three. It occurred to me after about the first hour that I hadn’t eaten anything since about noon that day. By this point, Nora was just about back to her normal self. She was waving at other babies in the ER and asking questions about the other “sick” people. I finally spotted a vending machine and was quite relieved only to realize that I had zero cash in my wallet. At that point, Nora was also asking for water. I felt so unprepared, but then again, this is the Emergency Room and who is ever prepared to be there? We took a few walks to the bathroom, not necessarily to go, but more to pass the time and I noticed a man filling the vending machines. I asked if any of the machine took credit cards, even though I was pretty sure the answer was no. The guy said no, but gave me 2 bottles of water for free. He didn’t have the key to the machine with the food in it though.
Not too long after that, we were called back to a room. We waited some more, and then a doctor finally came in. She looked at the wound and said it definitely needed to be stitched and that it was pretty deep. I was fearing it though sort of expected it. Nora was lucky to have gotten off with just dermabond last time. So I texted Scott to update him and then we got ready. Nora was pretty tired at this point and but she was very cooperative. She sat up on the table, laid down when told, and barely flinched when they put the numbing stuff in her wound. They did have to wrap her up in a sheet so she couldn’t move while being stitched, but that’s procedure anyway. Since the wound was so deep that had to put a mattress stitch underneath and then five more stitches on the outside. They gave her some Tylenol for the pain, bandaged her up and we were on our way home – over three hours later!
It was a crazy, scary night that I’ll never forget. But now, almost a month later, she is healing well and I know she’ll be fine. We use Mederma a few times a day and cover the area with a band aid when we go out in the sun. The wound is off to the side on her forehead and closer to her hairline than her eyebrow so hopefully it will stay out of sight for the most part. Of course, she had to choose the brightest most colorful band aids they sell to wear out in the sun. It suits her though. She’s the type of kid that when injured she wants everyone to know about it!
So that’s the story of my second kid, under the age of three, having stitches in her forehead. But if you think I’m finished with the head injuries, you’re wrong! Just yesterday, Nora was playing out on the porch and she came in to show me something. She has a tendency to carry more than she can handle and when she came in through the door, she wasn’t paying attention and walked right into the door knob. No, she didn’t cut herself but she does have a little bruised egg on the opposite side of her forehead.
I’m seriously thinking of getting the kid a helmet. ::Sigh::
I seem to get a lot of hits to my blog by people searching for dermabond, scars and facial lacerations. It’s not much of a surprise to me considering the posts here and here. So, I decided to do a little follow-up, if you will, on how things have turned out for my girls, scar-wise. If you remember (or if you go back and read those two posts) Brinley and Nora both had accidents involving facial lacerations. Brinley was just over two years old and Nora was about 16 months old. Brinley had six stitches and Nora was treated with dermabond.
Over two and a half years later, Brinley’s scar is barely noticed at all. It’s about an inch long and luckily it’s right in her hair line. We’ll still be sure to put sunblock on it whenever we’re out in the sun for long periods of time, but for the most part it’s completely off of our radar. We never see it and it has no lasting effects. Here is a picture of her scar as it looks today (with me pulling her hair back off of it):
Nora’s scar hasn’t had as much time to heal as Brinley’s but so far I am happy with the results. If you remember from my original post on it, I was a little bummed that her pediatrician said he’d probably have stitched it instead of using dermabond, but it was too late. He obviously wasn’t there when we were in the ER and he didn’t see the original wound but that was his opinion. It made me a little upset that we may have missed an opportunity to have the best outcome for her. But now that time has passed and the dermabond has long since fallen off, I couldn’t be happier about the appearance of her scar. It’s virtually unnoticeable! Unlike Brinley’s, Nora’s is more in the front and center (well a little off to the left) of her forehead. So a visually noticeable scar there wouldn’t be so great. I guess she could always opt for bangs, but I’m not a huge bangs fan. I can honestly say that her scar is never mentioned or noticed by anyone. Again, we’ll use sunscreen and all that, but it’s a non issue to us. Here is a picture of Nora’s scar as it looks today:
Nora’s scar wasn’t a nice straight line like Brinley’s is. But honestly, I had to circle it in the picture because otherwise you’d never have been able to find it. It’s more of a little bump in her skin than anything. Hopefully it stays the way it is or gets even better.
So there you have it. I know the wounds were different and they were on different kids, but that’s my experience with both stitches and dermabond. I wouldn’t say that one was better than the other because honestly I’ll never know that. I will say, though, that I am very happy that we went with the dermabond for Nora. I think that she’d have a much more noticeable scar with stitches.
After having had to take both of my daughters to the Emergency Room in their first two years of life for facial lacerations (try saying that five times fast!) I’ve done quite a bit of research on the best ways to reduce scarring in young children. There are lots of helpful tips on the internet and I’ve learned quite a few things both there and from doctors, a plastic surgeon included. When my girls’ injuries first happened, I was so caught up on how they would each be left with a terrible scar. It really bothered me and I was, and still am, determined to make them as invisible as possible.
So, I’m going to share with you some of the things that I have learned in case you are ever in this position with your child, or even yourself! Please note that my experiences are both with facial lacerations in the forehead region so other areas of the body may have different protocol.
First, if you have any doubt in your mind whether or not the injury may need to be stitched, go to the Emergency Room. If a wound does require stitches they must be done within a certain amount of time, generally six to eight hours, but the sooner the better. It’s also important to control the bleeding as much as possible by putting pressure on the wound.
When you arrive at the emergency room, be sure to tell the intake person about how the wound happened, whether or not the person lost consciousness, and the severity of the bleeding. They should ask you most of this anyway, but be sure to volunteer it if not asked. Then you will have to wait which is the hard part.
Once you are taken back into the room, be sure that you or your child are being treated by a doctor and not just a physician’s assistant or nurse. In the case of a facial laceration, or would in another very obvious/prominent area of the body, you may want to seek more than one opinion on it’s treatment. This is a piece of advice that I wish I had known before taking Nora in. Also, if the wound is going to require stitches you always want to ask for a plastic surgeon to perform them whenever possible. Remember you are the patient/parent and you have a right to ask.
Whatever the case may be, stitches, Derma-bond or just a dressing, be sure to care for it properly when you get home. When Brinley had her stitches we had to put an antibiotic ointment with a band-aid on it for a week and then we had to take her in to the doctor to have the stitches removed. For Nora’s Derma-bond we were told not to put any type of ointment on it and not to get it wet for the first 24 hours. So be mindful of the proper care because it’s not always the same.
When I took Nora in to see her pediatrician for her follow-up visit, that is when I found out that I should have gotten a second opinion on the way in which her wound was treated. Her pediatrician felt that since it was a facial wound that it probably should have been stitched. Though he didn’t see the wound fresh so he couldn’t say that matter-of-factly. It killed me to know that I may not have done the right thing for her but I really had no idea that I should have pushed back. Lesson learned.
The most important factor in minimizing scars though, is the care that comes after the stitches are removed or the Derma-bond falls off. The number one most important thing is to make sure that you apply sun screen to the area every single day for at least a year. Even if it doesn’t seem sunny out or it’s the dead of winter, the virgin skin can still burn very easily. You also want to massage the scar to increase the circulation and help promote healing. It is recommended to use vitamin E oil and massage it into the scar. It’s not known whether the oil itself helps diminish the scar or if it’s the massaging. Maderma or some other scar reducing ointment is also recommended.
I am happy to report that Brinley’s scar from almost two years ago, where she received six stitches, is hardly visible at all. Granted it is in her hairline, but it still healed very well. Only time will tell with Nora’s but I have very high hopes. It already looks 100 times better since the Derma-bond has fallen off. In fact, we were at a BBQ this past weekend and no one even noticed it.
Every time I think about one of my girls being “scarred for life” it really eats away at me. But I heard something on the radio this weekend that made me look at scars in a bit of a different light…. “A scar is like a tattoo, but with a much better story.”
Disclaimer: I am not a doctor and I do not claim to be one. I also don’t play one on TV. The advice given above is based solely on my experience of having two daughters who have both visited the ER and were treated for facial lacerations. Please be sure to seek your own medical advice from a professional.
Raising two daughters is truly an amazing thing. My girls are 2 years and 8 months apart. They annoy the crap out of each other yet love each other so much. The dynamic is both heartwarming and nerve wracking at the same time. From the moment Nora was capable, she has made it a priority to do exactly what her big sister is doing. She mimics Brinley to a T. If Brinley is reading a book, Nora is reading a book. If Brinley is coloring, Nora is coloring. When Brinley brushes her teeth, Nora wants to brush hers. If Brinley is having a drink, Nora needs a drink. If Brinely has to go potty, Nora has to go potty. And it’s not just the activity that she has to copy, it has to be done the same way – sitting in the same chair, coloring the same picture, going through the same motions, using the same cup.
It’s crazy how much she wants to be just like her big sister. Last night, Nora really proved just how much she wants to be like her big sister. You see, a little less than two years ago, Brinley had her first visit to the ER. She fell and hit her head on a wrought iron fire place basket and wound up with six stitches right in her hairline on her forehead. Nora wasn’t yet born back then, but she was with us through it. She was a mere 8 weeks along in gestation. I know she was taking note of it all.
How do I know this? Well yesterday we had a BBQ. It was raining so it turned into an indoor event. After we had enjoyed our food we headed down to the family room to play some Guitar Hero. The kids were making a phenomenal mess with the toys and the adults were taking turns playing Wii and supervising the kiddos. It was just about 7pm and we were getting ready to call it a night when we heard a loud thud. We all turned toward the direction of the sound and saw Nora face down on the brick fireplace hearth. I ran over to her and turned her over and she had a gash on her forehead that was bleeding a lot. I picked her up, brought her upstairs and put pressure on the wound. It just so happened that we had both a doctor and a nurse in the house. Once the bleeding stopped, both doctor and nurse had taken a quick look and Scott stopped vomiting (he has a weak stomach at the sight of blood), we got in the car and headed to the hospital. We left Brinley home in good hands with our friends.
Now I am not a fan of Emergency Rooms at all (not that I can imagine anyone is). The wait is always very long and it’s no fun to see all of these sick/hurt people waiting for care. But I have to say, it was as good of an experience as a visit to the ER could possibly be. We were in and out of there in less than an hour and a half. Nora, unlike her sister, did not require stitches. The doctor was able to use Derma-Bond glue to close the wound. Though both girls hurt themselves on or around a fireplace and had their wound on the same side of their forehead, Brinley’s was up much higher near her hairline while Nora’s is more right in the front of her forehead. It fits her personality. She’s a bruiser.
It has been an eventful past few days to say the least. On Thursday, Brinley had her first trip to the Emergency Room. She fell while playing with her friend Deacon and hit her head. At first she was crying a lot but within ten minutes she was asking to get down to play again. However, the cut looked big enough that I was concerned so I decided to take her to the ER to have it looked at. I also wanted to make sure she did not have a concussion (even though she was acting just fine).
So we headed to the hospital and arrived around 5pm. I’ve come to realize that the term “Emergency” Room is used quite loosely. I showed up with my poor little, bleeding baby girl and the woman at the check in desk didn’t even look up at me. She just nodded and said, “just a few minutes dear.” I nearly jumped over the desk at her. However, she ended up being quite nice. We were at the ER from 5pm until about 10pm from start to finish. Brinley did extremely well. The doctors and nurses were awesome and made the entire experience as pleasant as they could. I honestly don’t think Brinley felt a thing and she was such a champ. She got six stitches near her hairline on the top right (left if looking at her) of her forehead. I am so proud of her!!